Last updated: July 14, 2026
Bottom line
Most Wisconsin families should start with BadgerCare Plus. It is Wisconsin’s main health coverage program for eligible children, pregnant people, parents, caregivers, and other adults under age 65 with low income. You can apply at any time. There is no yearly open enrollment period.
Children and pregnant people can qualify at higher income levels than adults. A child may qualify even when the parent does not. If you are over the limit, waiting for a decision, or uninsured, you may still find help through community clinics, the Marketplace, family planning services, or the Wisconsin Well Woman Program.
This guide explains access to coverage and care. It is not medical advice. For more help paths, see the ASMOM national health care guide, Medicaid and CHIP guide, and Wisconsin help page.
Urgent health help
Call 911 if you or your child may be in immediate danger or has a medical emergency. For suicide, mental health, or substance use crisis support, call or text 988. Wisconsin also explains the service on its 988 crisis page.
Call 211 for local help with clinics, shelter, food, medicine, transportation, and other urgent needs. 211 Wisconsin is free, confidential, and open 24 hours a day.
If you are pregnant and need care now, contact a clinic or hospital and apply for coverage the same day. Ask whether the clinic offers prenatal care, a sliding fee, payment help, or help applying. The ASMOM Wisconsin emergency guide also lists other fast-help paths.
Where to start
For most families, the fastest first step is ACCESS Wisconsin. One application can check several programs, including BadgerCare Plus and FoodShare. You may also apply by phone, mail, or in person through your county or Tribal agency.
Do not wait until you have every paper. Submit the application, then send proof when the agency asks for it. Keep screenshots, confirmation numbers, and copies of anything you upload or mail.
Quick reference
| Your need | Best starting point | Reality check |
|---|---|---|
| Coverage for an adult | Apply for BadgerCare Plus | The adult income limit is lower than the child and pregnancy limits. |
| Coverage for a child | Include every child on the application | A child may qualify even if the parent does not. Some higher-income families may owe a child premium. |
| Pregnancy coverage | Report the pregnancy when applying | Full BadgerCare Plus and the Prenatal Plan have different rules and different postpartum coverage. |
| No insurance today | Call a community clinic | Hours, fees, and new-patient rules vary. Call before going. |
| Coverage ending | Read the notice and act | Renewal and appeal dates matter. Keep the notice. |
BadgerCare Plus in Wisconsin
BadgerCare Plus is full Medicaid coverage for eligible Wisconsin residents ages 0 through 64. It can help pay for doctor visits, hospital care, prescriptions, lab tests, vaccines, urgent care, emergency care, pregnancy services, mental health care, dental care, and other covered services. The state’s covered services page explains common benefits and possible copays.
BadgerCare Plus is not cash assistance. It does not send grant money to a family. It pays for covered health services through Wisconsin Medicaid and, for many members, a health maintenance organization.
Who may qualify
Eligibility depends on age, household size, income, Wisconsin residency, pregnancy, tax relationships, and other case facts. Citizenship or immigration rules also affect which type of coverage is available. Apply even if you are close to the limit because the state, not an online estimate, makes the final decision.
How to apply
Use the state’s application guide for online, phone, mail, and in-person choices. ACCESS is usually the fastest choice. A local worker may contact you if more information is needed.
For questions about an active case, card, health plan, covered service, or provider, call ForwardHealth Member Services at 800-362-3002, Monday through Friday from 8 a.m. to 6 p.m. The state lists this number on its BadgerCare contacts page, along with other contact choices.
Practical tip
Put every person who lives with you on the form and explain how each person is related. The agency will decide who belongs in each program household. Leaving someone off can slow the case or cause the wrong result.
BadgerCare Plus income guide for 2026
Wisconsin’s current table is effective February 1, 2026, through January 31, 2027. It uses gross monthly income before most deductions. The numbers below are a guide only. The official income limits table should be checked before you apply.
| Family size | Adult limit | Child premium threshold | Pregnancy and child limit |
|---|---|---|---|
| 1 | $1,330.00 monthly | $2,673.30 monthly | $4,069.80 monthly |
| 2 | $1,803.33 monthly | $3,624.69 monthly | $5,518.19 monthly |
| 3 | $2,276.67 monthly | $4,576.11 monthly | $6,966.61 monthly |
| 4 | $2,750.00 monthly | $5,527.50 monthly | $8,415.00 monthly |
| 5 | $3,223.33 monthly | $6,478.89 monthly | $9,863.39 monthly |
The adult column is 100% of the federal poverty level. The child premium threshold is 201%. The pregnancy and child limit is 306%. A premium threshold is not the same as a final cutoff. Above that point, some children may still qualify but have a monthly premium.
Do not decide from income alone
Pregnancy changes family size. Income that changes each week may need more proof. Self-employment and tax filing details may also affect the review. Apply and let the agency calculate your case.
Children’s Medicaid and CHIP coverage
Wisconsin provides children’s Medicaid and Children’s Health Insurance Program coverage through BadgerCare Plus. A child under 19 can qualify at a higher income level than an adult parent. Apply for the whole family instead of assuming everyone will get the same answer.
Most children under age 19 keep Wisconsin Medicaid or BadgerCare Plus for 12 months once enrolled, even if household income changes during that period. The state explains this rule in its BadgerCare Plus FAQ. Coverage can still end for limited reasons, such as moving out of Wisconsin or asking to close it.
Keep the child’s address and household information current. Open all letters and check ACCESS for requests. If your child has a disability or special health need, the ASMOM disability help guide can help you plan other questions.
Pregnancy and postpartum coverage
Pregnant Wisconsin residents may qualify for full BadgerCare Plus at the higher pregnancy income limit. Report the pregnancy and expected due date. Include the unborn baby or babies when the application asks about household size.
Full BadgerCare Plus
Most people who have full-benefit BadgerCare Plus or Medicaid when a pregnancy ends now receive 12 months of postpartum coverage. Wisconsin made this policy effective June 1, 2026. The state’s postpartum policy memo also explains transition rules for some people whose old 60-day coverage ended in March, April, or May 2026.
This extended coverage is usually continuous through the end of the month in which the 365th day after the pregnancy ends falls. It can end early in limited cases, such as moving out of Wisconsin or asking to end coverage.
BadgerCare Plus Prenatal Plan
The Prenatal Plan may cover prenatal visits, prescriptions, labor, and delivery for some pregnant people who cannot get full BadgerCare Plus because of immigration or citizenship status, or because they are in jail or prison. A Social Security number is not required for an undocumented applicant.
The Prenatal Plan is not the same as full BadgerCare Plus. Its benefits end after the month the pregnancy ends, and it does not provide the 12-month postpartum coverage described above. Ask the agency which program approved your case.
For wider support before and after birth, use the ASMOM pregnancy and newborn guide and the Wisconsin WIC guide.
Other Wisconsin health programs
Family planning services
The Family Planning program covers certain birth control, sexually transmitted infection services, and preventive care tied to family planning. In 2026, the listed monthly income limit is $4,069.80 for one person. Other rules also apply.
Breast and cervical screening
The Well Woman Program helps eligible women with little or no insurance get breast and cervical cancer screening. Local coordinators help check age, income, insurance, and other rules.
Coverage for noncitizens
Wisconsin has full and limited health coverage paths for some noncitizens. Immigration rules are case-specific. Ask the agency or a trusted navigator which application is right for you instead of stopping the process on your own.
Low-cost clinics and dental care
If you have no insurance, are waiting for approval, or cannot find a provider, use Wisconsin’s low-cost clinic finder. You can also search the federal health center locator for community health centers near your ZIP code.
Community health centers may offer primary care, pregnancy care, dental services, behavioral health care, and pharmacy help. Fees may use a sliding scale based on income. Not every clinic offers every service, and some have waiting lists, so call first.
For dental care, use the state’s dental clinic map. It lists free and lower-cost clinics by county. The ASMOM Wisconsin dental guide gives more steps for finding care.
Check before the visit
Ask whether the clinic accepts your HMO or ForwardHealth card, whether it is taking new patients, and what proof to bring. A clinic listed online may change hours or stop taking new patients.
Mental health support and medical rides
BadgerCare Plus can cover mental health and substance use services. Member Services can help you find a provider or explain your plan. For a crisis, use 988. For pregnancy or postpartum emotional support, call or text the National Maternal Mental Health Hotline at 833-852-6262. Wisconsin lists this service on its family health page.
Some BadgerCare Plus and Medicaid members can get non-emergency medical transportation when they have no other way to reach a covered appointment. Wisconsin’s medical ride program may offer a ride, bus fare, or mileage help based on the member’s needs. Routine rides often need advance notice.
The ASMOM Wisconsin transportation guide covers other ride options when Medicaid transportation does not fit.
How to apply and what to gather
You can apply online through ACCESS, by phone, by mail, or in person. The official application page links to the paper BadgerCare Plus packet and the list of county and Tribal agencies.
| Information | Examples | Why it helps |
|---|---|---|
| Identity | Name, birth date, Social Security number when required | Helps the agency match each applicant. |
| Home and household | Address, people in the home, relationships | Helps set residency and household size. |
| Income | Recent pay stubs, employer details, self-employment records | Shows current gross income. |
| Other income | Unemployment, Social Security, pension, child support when requested | Some income must be reviewed. |
| Other insurance | Employer plan, Marketplace plan, policy details | Helps the agency check other coverage. |
| Pregnancy | Due date and number of babies | May change household size and coverage. |
Use the ASMOM documents checklist to organize copies. If a paper is missing, ask whether another record can be used and note the deadline.
Renewals and keeping coverage
BadgerCare Plus and Medicaid cases must be renewed. Wisconsin may renew a case automatically when it has enough current information. If not, the state sends a renewal packet. Check your date in ACCESS or the MyACCESS app.
The renewal instructions say many health programs allow a late renewal for up to three months after the renewal month. A coverage gap can still happen, so do not wait. Send the renewal and missing proof as soon as possible.
Report major changes, including a new address, a pregnancy, a move, a marriage or divorce, changes in household members, and certain income or insurance changes. Keep your mailing address current so notices reach you.
Common renewal problems
- A packet went to an old address.
- A photo was blurry or missed a page.
- The agency asked for newer pay stubs.
- A deadline was missed because the notice was not opened.
What to do if denied or delayed
Read the notice from start to finish. It should explain the decision, the effective date, and how to ask for a fair hearing. Do not rely only on what someone says by phone. Keep the written notice.
If you disagree, Wisconsin’s fair hearing page explains how to send a signed request. A request received before the effective date may allow medical assistance to continue in many cases while the appeal is pending, but overpaid benefits may later be collected. Follow the instructions on your own notice.
For free, unbiased enrollment help, contact Covering Wisconsin. Navigators can help with BadgerCare Plus, HealthCare.gov, charity care, and some appeal problems. The ASMOM benefits problem guide also explains how to track calls and missing documents.
If BadgerCare Plus or CHIP ends because you are no longer eligible, you may qualify for Marketplace coverage. HealthCare.gov says you can enroll up to 60 days before Medicaid or CHIP ends and up to 90 days after it ends. Start with the Medicaid transition guide instead of waiting for someone to contact you.
For a legal problem tied to benefits, discrimination, or another family issue, use the ASMOM Wisconsin legal guide. Legal aid cannot promise a result, but it may explain your rights and deadlines.
Phone scripts
Calling the benefits agency
Hello, my name is _____. I applied for health coverage on _____. Can you tell me the case status, what proof is still missing, and the deadline to send it?
Calling Member Services
Hello, I have BadgerCare Plus or Medicaid. I need help with my card, health plan, covered services, or finding a provider. What is the next step in my case?
Calling a clinic
Hello, I am uninsured or waiting for coverage. Do you offer sliding-fee care, and are you taking new patients? What documents and payment should I bring?
Calling after a denial
Hello, I received a notice dated _____. Please explain the reason, the effective date, and the fair hearing deadline. I also need to know whether my coverage can continue during an appeal.
Backup options while coverage is not active
Ask a clinic or hospital about financial assistance, charity care, payment plans, or a sliding fee. Use a community health center for primary care and ask whether it can help with prescriptions. Call 211 for local clinics and transportation. If your income is too high for BadgerCare Plus, check Marketplace plans with a navigator.
Health needs often come with food and household costs. The ASMOM Wisconsin FoodShare guide and Community Action guide can help you check related support.
Resumen en español
En Wisconsin, muchas familias empiezan con BadgerCare Plus. Los niños y las personas embarazadas pueden tener límites de ingresos más altos que otros adultos. Puede solicitar en ACCESS Wisconsin, por teléfono, por correo o en una agencia local.
La cobertura posparto de BadgerCare Plus ahora puede durar 12 meses para la mayoría de las personas que tenían cobertura completa cuando terminó el embarazo. El Prenatal Plan tiene reglas distintas y no incluye esos 12 meses.
Si no tiene seguro, llame a un centro de salud comunitario y pregunte por una tarifa según sus ingresos. Si recibe una carta de negación o renovación, revise la fecha, guarde copias y pida ayuda a un navegador o a asistencia legal.
FAQ
Can single mothers get Medicaid in Wisconsin?
Yes, if they meet the rules for BadgerCare Plus or another Wisconsin Medicaid program. A child may qualify even when the parent does not.
Can I apply for BadgerCare Plus any time?
Yes. BadgerCare Plus has no yearly open enrollment period. You can apply when you need coverage or when your household changes.
What are the 2026 income limits?
The adult limit is 100% of the federal poverty level, while children and pregnant people may qualify up to 306%. The exact monthly amount depends on family size.
How long does postpartum Medicaid last in Wisconsin?
For most people with full-benefit BadgerCare Plus or Medicaid when the pregnancy ends, postpartum coverage now lasts 12 months under the policy effective June 1, 2026.
Does the Prenatal Plan include postpartum coverage?
No. The BadgerCare Plus Prenatal Plan ends after the month the pregnancy ends. It does not include the 12-month postpartum period for full-benefit members.
What if my renewal is late?
Many Wisconsin health programs allow a late renewal for up to three months after the renewal month, but a coverage gap may occur. Send it as soon as possible.
What can I do after a denial?
Read the notice, check the effective date and hearing instructions, and gather proof. A navigator or legal aid office may help you understand the next step.
About this guide
This guide uses official federal, state, local, and other high-trust nonprofit and community sources mentioned in the article.
A Single Mother is independent and is not a government agency, benefits office, lender, law firm, medical provider, or tax advisor.
Program rules, funding, local availability, and eligibility can change. Always confirm details with the official program before you apply or make decisions.
Verification: Last verified July 14, 2026, next review October 14, 2026.
Corrections: If you see something wrong or outdated, email suggestions@asinglemother.org.
Disclaimer: This article is for general information only. It is not legal, financial, medical, tax, immigration, disability, safety, or government-agency advice.